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Occupational Therapy Assistant > F&A II Ch. 7 Assessment of JROM > Flashcards

F&A II Ch. 7 Assessment of JROM Flashcards

1
Q

The extent of movement that occurs at a joint is?

A

Range of motion (ROM)

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2
Q

Name 2 types of joint movement.

A
  • Active Range of Motion (AROM)

- Passive range of motion (PROM)

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3
Q

The arc of motion through which the joint passes when voluntarily moved by muscles acting on the joint.

A

AROM

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4
Q

The arc of motion through which the joint passes when moved by an outside force.

A

PROM

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5
Q

Which is normally greater, AROM or PROM?

A

PROM

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6
Q

What are the 3 principals of joint measurement?

A

1- The degree & type of motion that will occur at a specific joint
2- Average & normal ROM
3- The position of the OTP & the Pt during measurement

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7
Q

What is the term for the minimum ROM necessary to execute performance in essential areas of occupation & daily life activities without the use of special equipment.

A

Functional range of motion

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8
Q

Name the 3 planes that motion occurs in.

A

1- sagittal
2- frontal
3- horizontal

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9
Q

Name the 4 parts of the goniometer.

A

1- Stationary Bar (proximal)
2- Protractor
3- Movable bar (distal)
4- Dial (axis/fulcrum)

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10
Q

In the anatomical position, flexion & extension occur in what plane & around what axis?

A

Sagittal plane & frontal (coronal) axis

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11
Q

In the anatomical position, abduction & adduction occur in what plane & around what axis?

A

Frontal (coronal) plane & anteroposterior axis

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12
Q

In the anatomical position, shoulder internal & external rotation occur in what plane & around what axis?

A

Horizontal plane & sagittal (vertical) axis

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13
Q

When determining a Pt’s effective ROM, how may the OTA determine the closest approximation of what is normal?

A

The Pt’s unaffected extremity provides the closes approximation of what is normal for that individual.

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14
Q

When is limitation of ROM indicated for joint measurements?

A

The start position is not 0*

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15
Q

Name the 3 conditions of the scapular musculature that effect the glenohumeral joint ROM.

A

1- Spastic
2- Contracted
3- Orthopedically restricted

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16
Q

ROM measurements are indicated in how many increments?

A

5* increments

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17
Q

Name the 5 types of goniometers.

A 
1-  Full circle
2-  Radiopaque
3-  Plastic
4-  Finger
5-  Plastic small
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18
Q

How may burn injuries effect ROM?

A

Significant burn injuries often develop skin adhesions & scar formations that decrease joint movement.

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19
Q

Name the disease process that may cause joint stiffness & deformity.

A

Arthritis

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20
Q

How may the OT practitioner preserve function for the arthritis Pt?

A
  • splints
  • positioning
  • exercise
  • joint protection principles
  • assistive devices
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21
Q

What exercises may be incorporated to increase ROM?

A
  • Active & passive stretching
  • Resistive exercise
  • Exercise equipment that use pulleys
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22
Q

What functional activities may be used to increase ROM?

A
  • Reaching
  • Catching a ball
  • Table-top activities
  • Throwing a bean bag
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23
Q

Name alternative stretching exercises to promote flexibility & ROM.

A
  • Yoga
  • Tai Chi
  • Pilates
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24
Q

What factors determine how the examiner holds the goniometer & supports the body part being measured?

A
  • Muscle weakness
  • Presence or absence of joint pain
  • AROM measurements
  • PROM measurements
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25
Q

Name the associated girdle motion of shoulder flexion.

A
  • Abduction
  • Lateral tilt
  • Slight elevation
  • Slight upward rotation
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26
Q

Name the associated girdle motion of shoulder extension.

A
  • Depression
  • Adduction
  • Upward tilt
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27
Q

Name the associated girdle motion of shoulder abduction.

A
  • Upward rotation

- Elevation

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28
Q

Name the associated girdle motion of shoulder adduction.

A
  • Depression
  • Adduction
  • Downward rotation
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29
Q

Name the associated girdle motion of shoulder horizontal abduction.

A
  • Adduction

- Reduction of lateral tilt

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30
Q

Name the associated girdle motion of shoulder horizontal adduction.

A
  • Abduction

- Lateral tilt

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31
Q

Name the associated girdle motion of shoulder internal rotation.

A
  • Abduction

- Lateral tilt

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32
Q

For shoulder flexion, what is the position of the goniometer?

A

Axis is center of humerus just distal to acromion process on lateral aspect of humerus. Stationary bar is parallel to trunk, & movable bar is parallel to humerus.

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33
Q

For shoulder flexion, what is the direction of movement?

A

Pt’s arm is raised in front of body in sagittal plane of movement.

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34
Q

For shoulder flexion, what is the position of the Pt?

A

Seated or supine with humerus in neutral position.

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35
Q

For shoulder extension, what is the position of the Pt?

A

Seated or prone, with no obstruction behind humerus. Humerus is in neutral position.

36
Q

For shoulder extension, what is the position of the goniometer?

A

Axis is center of humerus just distal to acromion process on lateral aspect of humerus. Stationary bar is parallel to trunk, & movable bar is parallel to humerus.

37
Q

For shoulder external rotation, alternate position, what is the position of the goniometer?

A

Axis is on olecranon process of elbow, & stationary bar & movable bar are parallel to forearm.

38
Q

For the elbow extension to flexion, what is the position of the subject?

A

Standing, sitting, or supine with humerus adducted & externally rotated & forearm supinated.

39
Q

For the elbow extension to flexion, what is the position of the goniometer?

A

Axis is placed over lateral epicondyle of humerus at end of elbow crease. Stationary bar is parallel to midline of humerus, & movable bar is parallel to radius.

40
Q

For the forearm supination, what is the position of the subject?

A

Seated or standing with humerus adducted, elbow at 90*, & forearm in midposition.

41
Q

For the forearm supination, what is the position of the goniometer?

A

Axis is at ulnar border of volar aspect of wrist, just proximal to ulna styloid. Stationary bar is perpendicular to the floor, & movable bar is resting against volar aspect of wrist.

42
Q

For the forearm supination, alternate position, what is the position of the subject?

A

Seated or standing with humerus adducted, elbow at 90*, & forearm in midpositon. A pencil is placed in subject’s hand & held perpendicular to the floor.

43
Q

For the forearm supination, alternate position, what is the position of the goniometer?

A

Axis is over midshaft of third proximal phalanx. Stationary bar is perpendicular to floor, & movable bar overlays shaft of pencil.

44
Q

For the forearm pronation, what is the position of the subject?

A

Seated or standing with humerus adducted, elbow at 90*, & forearm in miposition.

45
Q

For the forearm pronation, what is the position of the goniometer?

A

Axis is at ulnar border of dorsal aspect of wrist, just proximal to ulna styloid. Stationary bar is perpendicular to floor, & movable bar is resting against dorsal aspect of wrist.

46
Q

For the forearm pronation, alternate position, what is the position of the subject?

A

Seated or standing with humerus adducted, elbow at 90*, & forearm in midposition. A pencil is placed in subject’s hand & held perpendicular to the floor.

47
Q

For the forearm pronation, alternate position, what is the position of the goniometer?

A

Axis is over third proximal phalanx. Stationary bar is perpendicular to floor, & movable bar overlays shaft or pencil.

48
Q

For wrist flexion, what is the position of the subject?

A

Seated with forearm in midpositon & hand & forearm resting on table on ulnar border.

49
Q

For wrist flexion, what is the position of the goniometer?

A

Axis is on lateral aspect of wrist just distal to radial styloid in anatomic snuffbox. Stationary bar is parallel to radius, & movable bar is parallel to metacarpal of index finger.

50
Q

For wrist extension, what is the position of the subject?

A

Seated with forearm in midpositon & hand & forearm resting on table on ulnar border with fingers flexed.

51
Q

For wrist extension, what is the position of the goniometer?

A

Axis is on lateral aspect of wrist just distal to radial styloid in anatomic snuffbox. Stationary bar is parallel to radius, & movable bar is parallel to metacarpal of index finger.

52
Q

For ulnar deviation, what is the position of the subject?

A

Seated with forearm pronated & palm of hand resting flat on table surface. The third finger lines up with center of forearm.

53
Q

For ulnar deviation, what is the position of the goniometer?

A

Axis is on dorsum of wrist at base of third metacarpal. Stationary bar is positioned in center of forearm, & movable bar is parallel to third metacarpal.

54
Q

For radial deviation, what is the position of the subject?

A

Seated with forearm pronated & palm of hand resting flat on table surface. The third finger lines up with center of forearm.

55
Q

For radial deviation, what is the position of the goniometer?

A

Axis is on dorsum of wrist at base of third metacarpal. Stationary bar is positioned in center of forearm, & movable bar is parallel to third metacarpal.

56
Q

For MP flexion, what is the position of the subject?

A

Seated with forearm in midposition, wrist at 0* neutral, & forearm & hand supported on a firm surface on ulnar border.

57
Q

For MP flexion, what is the position of the goniometer?

A

Axis is centered on top of middle of MP joint. Stationary bar is on top of metacarpal, & movable bar is on top of proximal phalanx.

58
Q

For MP hyperextension, what is the position of the subject?

A

Seated with forearm in midposition, wrist at 0* neutral, & forearm & hand supported on a firm surface on ulnar border.

59
Q

For MP hyperextension, what is the position of the goniometer?

A

Axis is over lateral aspect of MP joint of index finger. Stationary bar is parallel to metacarpal, & movable bar is parallel to proximal phalanx. MP joint of fifth finger may be measured similarly. ROM of third & fourth fingers can be estimated by comparison.

60
Q

For PIP flexion, what is the position of the subject?

A

Seated with forearm in midposition, wrist at 0* neutral, & forearm & hand supported on a firm surface on ulnar border.

61
Q

For PIP flexion, what is the position of the goniometer?

A

Axis is centered on dorsal surface of PIP joint being measured. Stationary bar is placed over proximal phalanx, & movable bar is over middle phalanx.

62
Q

For DIP flexion, what is the position of the subject?

A

Seated with forearm in midposition, wrist at 0* neutral, & forearm & hand supported on a firm surface on ulnar border.

63
Q

For DIP flexion, what is the position of the goniometer?

A

Axis is on dorsal surface of DIP joint. Stationary bar is over middle phalanx, & movable bar is over distal phalanx.

64
Q

For flexion of the thumb, what is the position of subject?

A

Seated with forearm in 45* of supination, wrist at 0* neutral, & forearm & hand supported on a firm surface.

65
Q

For flexion of the thumb, what is the position of the goniometer?

A

Axis is on dorsal surface of MP joint. Stationary bar is over thumb metacarpal, & movable bar is over proximal phalanx.

66
Q

For interphalangeal flexion of the thumb, what is the position of the subject?

A

Seated with forearm in 45* of supination, wrist at 0* neutral, & forearm & hand supported on a firm surface.

67
Q

For interphalangeal flexion of the thumb, what is the position of the goniometer?

A

Axis is on dorsal surface of IP joint. Stationary bar is over proximal phalanx, & movable bar is over distal phalanx.

68
Q

What is the other term to describe carpometacarpal (CMC) extension of the thumb?

A

Radial abduction

69
Q

For radial abduction of the thumb, what is the position of the subject?

A

Seated with forearm pronated & palm down, resting flat on a firm surface.

70
Q

For radial abduction of the thumb, what is the position of the goniometer?

A

Axis is over CMC joint at base of thumb metacarpal. Stationary bar is parallel to radius, & movable bar is parallel to thumb metacarpal.

71
Q

What is the other term to describe Carpometacarpal (CMC) flexion of the thumb?

A

Palmar abduction

72
Q

For palmar abduction of the thumb, what is the position of the subject?

A

Seated with forearm at 0* midposition, wrist at 0*, & forearm & hand resting on ulnar border. Thumb is rotated & placed at right angles to palm of hand.

73
Q

For palmar abduction of the thumb, what is the position of the goniometer?

A

Axis is over CMC joint at base of thumb metacarpal. Stationary bar is over radius, & movable bar is over thumb metacarpal.

74
Q

For thumb opposition, what is the position of the subject?

A

Seated with palmar aspect of hand exposed.

75
Q

For thumb opposition, what is the position of the goniometer?

A

Distance between thumb & fifth finger pads is measured with a centimeter ruler.

76
Q

Which is less: FROM or the standard measurements with a goniometer?

A

FROM

77
Q

If deficits are noted in FROM, what may be used to obtain more information?

A

Standard evaluation of ROM

78
Q

What is the role of the OTA based on in joint measurement?

A

Service competency, state regulations, & facility policy

79
Q

What are the general principles of formal joint measurement?

A
  • The comfortable AROM is observed
  • The goniometer is correctly aligned
  • The OT practitioner notes discomfort, restriction, or crepitation
80
Q

What are the general principles of informal joint measurement?

A
  • Pt assumes a variety of normal positions

- the affected limb can be compared with the opposite limb

81
Q

What is the main concern for the general principles of joint measurement?

A

Functional range of motion

82
Q

When measuring the joint, when is the Pt not in the anatomical position?

A

Measuring for rotation

83
Q

When the progressive loss of joint range is part of the disease process, what is the goal of tx?

A

To preserve function

84
Q

Name 6 tx options for joint limitation & disease processes.

A 
1- exercise
2- splinting
3- positioning
4- joint protection principles
5- assistive devices
6- functional activities
85
Q

When performing joint ROM evaluation, when is Pt pain assessed?

A

Beginning, during, & end of session

Occupational Therapy Assistant (30 decks)

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